----Chief Complaint: Patient states that  her sugar is still high 350-420. Patient states that insulin does not seem to help. Patient would like to know what the doctor thinks she should do.  Please call to advise. Thank you. 

----Me: please verify her readings last 3 days and her current regimen

---Last three days of blood sugars
 5/1/21 fbs 209, pm 187
5/2/21 fbs 180, pm 265
5/3/21 fbs 115, pm 203
5/4/21 fbs 414 
Pt is taking Toujeo 170 units QHS ,  Novolog 20 units ac tid

----Me: 5/3 fasting good but 5/4 significantly high. Snacks at night? Recent steroids?

----Pt states she made rice cake and had that the night before.

----Me: @#$%^&